The best way to treat Ebola patients who reach America

By Celine Gounder
August 4, 2014

 Members of the media wait in front of Emory University Hospital after an ambulance carrying American doctor Kent Brantly, who has the Ebola virus, arrived via Dobbins Air Reserve Base in Atlanta, Georgia

Dr. Kent Brantly, an American physician stricken with Ebola, was evacuated this weekend from Liberia to Emory University Hospital in Atlanta, where he will receive treatment for the deadly virus. His colleague Nancy Writebol, also infected with the Ebola virus, returned to the United States on Tuesday. But many Americans have expressed outrage over transport of these Ebola patients into the United States.

This reaction is unjustified — and callous. In the United States, much more can be done for a critically ill Ebola patient than if he or she were on the ground in West Africa. We have intensive care units that allow for careful, continuous monitoring of blood pressure, oxygenation and organ function. Blood pressure may be supported with intravenous fluids and “pressor” medications like norepinephrine, which increase blood pressure. If organs begin to fail when blood pressures are low, we can use ventilators to support breathing or dialysis if kidneys aren’t working. Ebola patients have weakened immune systems and can acquire secondary infections, for which we have a much broader array of antimicrobials at our disposal in the United States.

Medical staff working with Medecins sans Frontieres prepare to bring food to patients kept in an isolation area at the MSF Ebola treatment centre in KailahunThe likelihood that other Americans could get Ebola from Brantly or Writebol is extremely small. Ebola is not airborne. It is spread through direct contact with a sick patient or infectious bodily fluids. Brantly and Writebol are being treated in a specialized unit, separate from other patients at Emory University Hospital. The healthcare workers staffing this unit will be working in shifts and have access to personal protective equipment. Hospital staff will follow the Center for Disease Control and Prevention’s infection control guidelines for management of contaminated fluids, materials, equipment and surfaces. This is in contrast to working conditions in Guinea, Liberia and Sierra Leone, where the disease has been spreading.

Ebola is a deadly virus for which there is no cure. It kills quickly and dramatically. And it is not the first disease that has inspired fear and stigma. In 1984, Ryan White was diagnosed with AIDS. The thirteen-year-old boy acquired HIV from a blood transfusion for hemophilia. At that time, we knew how HIV was transmitted — through sexual intercourse or blood — yet parents and school officials were afraid that White would transmit HIV to other students by touching them or sharing water fountains. White had to fight in court for his right to go to school.

It is no more likely that Brantly and Writebol’s arrival in the United States will result in an Ebola outbreak than White was to infect his classmates with HIV. There have been five patients with hemorrhagic fevers similar to Ebola in the United States over the last ten years, but none transmitted infection.

Brantly and Writebol became infected with Ebola in the course of heroic work, caring for patients with the virus. Like many other healthcare workers, police officers, fire fighters and soldiers, they were aware of the risks they might encounter in the line of duty. Bringing them to the United States for treatment presents minimal risk to the public, but it could dramatically improve their chances of survival. They deserve our compassion and the best medical care available.

 

PHOTOS: Members of the media wait in front of Emory University Hospital after an ambulance carrying American doctor Kent Brantly, who has the Ebola virus, arrived via Dobbins Air Reserve Base in Atlanta, Georgia August 2, 2014. REUTERS/Tami Chappell

Medical staff working with Medecins sans Frontieres (MSF) prepare to bring food to patients kept in an isolation area at the MSF Ebola treatment centre in Kailahun July 20, 2014. REUTERS/Tommy Trenchard

12 comments

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Finally, the voice of reason.

Posted by LenicGB | Report as abusive

This sort of panic is just plain stupid. I hope Dr. Brantley and Mrs. Writebol make complete and quick recoveries and I am glad that they both will have the opportunity to do so back here at home in the US.

Posted by SusyCrandall | Report as abusive

Love the article.

Posted by upspackageman22 | Report as abusive

It is a rather flimsy hook to rest the safety of millions on…this idea that Ebola is not airborne. The same super protective government that shuts entire cities down out of “safety and security” concerns for its “commander and chief” or evacuates airports over a spilled soda pop, is perfectly happy with the notion that a virus won’t mutate or be altered intentionally.

Posted by Kuldebar | Report as abusive

I hope people read this article to learn how to guide their emotions properly, this is as educated human beings.

Posted by kt1967 | Report as abusive

Hope they find a treatment/cure that will free these people from the awful disease.

Posted by sego | Report as abusive

What’s with the sudden obsession of importing Ebola patients to the US??

Very, very, strange.

Posted by Simplerman | Report as abusive

If we have no compassion, we have nothing. US extremists loading their guns with bibles to kill children who approach the border while the extremists Twitter, Facebook and Instagram photos of lunches and dinners or shoes and drinks. It is the amazing ignorance of such a large group of the US population that gains the attention of the media but holding a mirror up to these people excites the extremists whom if they disappeared from the face of the earth would never be missed.

Posted by SixthRomeo | Report as abusive

These people who are full of hate of government, refugees, civilization itself, etc need to be quarantined themselves.

This hatred is not who Americans are.

Posted by Flash1022 | Report as abusive

I sincerely hope the author’s confidence is justified. I can’t imagine what these families are going through, and pray no others have to experience this horrible disease.

Posted by rmilcik | Report as abusive

Finally the voice of reason, indeed. Thank you for this calm, educated and educational op-ed.

Posted by jlj | Report as abusive

@Kuldebar
Yours is the only actual voice of reason here, the rest are the rantings of blubbering sentimentalists. We are assured that the disease is transmitted only by contact with bodily fluids of the afflicted, not by airborne transmission. When someone treats the rest of us to a nice wet sneeze, are those not bodily fluids contained in the aerosol spewed at us?

Posted by JRTerrance | Report as abusive